Notes on Emergent Paradigms: Part 1
Metabolic Psychiatry, the Gut-Brain-Axis & the Variety of Therapeutic Frameworks
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This is the first in a new series on Emergent Paradigms—new science, frameworks, and interventions that portend a radical departure from current healthcare practices.
Of course, Psychedelics fit the mold but are only one of a handful of forthcoming advances that will make impacts on the future of health and wellbeing.
Or at least that’s our prediction.
A paradigmatic period occurs when the scientific community widely accepts a particular scientific paradigm, which guides research, theory development, and the interpretation of data.
And the end of one period must necessarily mark the beginning of the next.
I am not talking about the advent of psychedelics—although they are a part of it—but rather a broader, foundational understanding of the causes and factors of—and thus interventions for—mental illness specifically and human health and well-being broadly.
From the “brain chemistry” thesis that rose to prominence in the 1990s with the advent of SSRIs to the greater appreciation of the effects of early life events through the groundbreaking Adverse Childhood Experiences (ACE) Study and the impact of trauma—the list of causes and factors that contribute, directly or indirectly, to wellbeing or mental illness continues to expand.
Many of these causes, factors, and influences are so far removed from conventional thinking that their incorporation into healthcare and wellness settings is hard to fathom.
Furthermore, their development portends a breakdown of the silos that currently exist in science and medicine.
In today’s dispatch, I want to highlight a few of the relevant and related scientific and therapeutic paradigms that are coming of age, auspiciously at the same time as psychedelics undergoing rapid scientific and cultural reappraisal.
This is a continuation of our last post, which highlighted Transcranial Functional Ultrasound and its therapeutic application for neurodegenerative conditions and addiction.
Metabolic Psychiatry & Psychology
Consider the field of Metabolic Psychiatry which implies a radical departure from some core assumptions in the field of psychiatry–namely, the heterogeneity of diseases—and points to a potential common pathway.
The theory that many mental illnesses are downstream of metabolic dysfunction suggests that altered metabolism in the brain can explain the symptoms of mental disorders.
In the recently published Brain Energy, Christopher Palmer, a Harvard psychiatrist and founder of the Metabolic and Mental Health Program at Mass General, writes:
“...we have arrived at our common thread, the underpinning factor that lets us answer our tangled questions about causes and treatments, symptoms and overlaps. Mental disorders—all of them—are metabolic disorders of the brain.”
This theory implies that symptoms improve when metabolic function is restored—through therapeutics, nutrition, exercise, etc—symptoms improve.
As a harbinger of mainstream interest, NPR just ran a story on this topic as well (emphasis added):
“All of this data is strong enough to suspect that "metabolic problems may be more than just innocent bystanders," that they may, in fact, play a direct role in the development, severity or course of psychiatric conditions," says [Dr. Georgia] Ede.”
Next up is the implication of research on the Gut-Brain-Axis.
Related to, but different from, the role of metabolic function in the brain, the Gut-Brain-Axis refers to the complex communication system between the gut and the brain, encompassing neural, hormonal, and immunological signaling pathways.
As it turns out, the makeup of the microbiota in the intestines, the permeability of the gut lining, and the foods that we eat all contribute to elements of our biology that drastically affect mood, cognition, stress response, and susceptibility to mental illness.
The graph below plots the rise in studies evaluating the role of the microbiome on mental health conditions and looks a lot like the graph of psychedelic research.
An early pioneer in the field of the Gut-Brain-Axis is John Cryan who invokes the idea of “happy microbes; happy brains.”
“What is often forgotten, even by neuroscientists, is that there are more nerve cells in our gut than there are in our spinal cord. We also know that the microbes in the gut are similar to little factories producing various weird and wonderful chemicals that our bodies wouldn’t make otherwise. And factories are dependent on the quality of the workers and the raw materials which come from one’s diet.”
Diversity of Therapeutic Frameworks
Another trend we are seeing is the ‘Cambrian Explosion’ of psychotherapeutic frameworks that are remixing traditional psychodynamics, spirituality, and neuroscience in novel and seemingly impactful ways.
A few examples are Somatic Experiencing, popular in the treatment of trauma; Internal Family Systems a system based on ‘parts and Coherence Therapy, a framework that understands undesireable symptoms, like addiction, as neccessary based on unconscious emotional schema.
The expansion in the number and variety of psychotherapeutic frameworks is a reflection of the evolving understanding of human psychology, the diversification of client needs, and the growing body of research supporting different approaches to mental health treatment.
What is particularly exciting are the practitioners from these and other modalities who are modifying these frameworks for Psychedelic Assisted Therapy—one such example is Psychedelic Assisted EMDR.
As psychotherapist, Max Wolff posits:
“When behavior therapy emerged in the 1950s, it was not unanimously recognized as a legitimate form of psychotherapy. It has since developed into a thoroughly established, diverse platform for psychotherapy integration. Something similar might happen with psychedelic therapy.”
In. future Emergent Paradigm series, we’ll look at advances in:
Meditation and Contemplative Neuroscience
The Free Energy Principle and Predictive Mind Hypothesis
The Science of Interoception
Let us know what you think in the comments or reply directly to this email!